Stakeholder Perspectives on CMS’s 2025 Notice of Benefits and Payment Parameters: Consumer Advocates
The Biden administration will soon finalize its annual rulemaking for the Affordable Care Act Market...
Posts tagged with: network adequacy
Blog Posts:
Stakeholder Perspectives on CMS’s 2025 Notice of Benefit and Payment Parameters: Health Insurers and Brokers
The Biden administration will soon finalize its annual rulemaking for the Affordable Care Act Market...
Proposed 2025 Payment Rule: Marketplace Standards And Insurance Reforms
Last month, the Biden administration proposed changes to Affordable Care Act (ACA) Marketplace polic...
September Research Roundup: What We’re Reading
As we fall into autumn weather, CHIR continues to keep up with the latest health policy research. In...
Stakeholder Perspectives on CMS’s 2024 Notice of Benefit and Payment Parameters: State Insurance Departments and Marketplaces
The Biden administration has proposed new rules for the Affordable Care Act’s (ACA) marketplaces i...
Stakeholder Perspectives on CMS’s 2024 Notice of Benefits and Payment Parameters: Consumer Advocates
The Biden administration is poised to finalize new rules governing the Affordable Care Act Marketpla...
February Research Roundup: What We’re Reading
Along with “Health Policy Valentines,” February brought a host of new health policy research. Th...
December Research Roundup: What We’re Reading
Happy New Year! The holiday season may be over, but health policy researchers continue to bestow gif...
May Research Roundup: What We’re Reading
This month, the CHIR team celebrated the end of the school year with new health policy research. For...
Standards for Provider Network Adequacy in Medicaid and the Marketplaces
Beginning in 2023, CMS will require QHP provider networks for plans sold on the federal marketplace ...
New Georgetown Report on Medicaid and Marketplace Network Adequacy
A recently published report from Georgetown's Center on Health Insurance Reforms and Center for Chil...
Stakeholder Perspectives on CMS’s 2023 Notice of Benefit and Payment Parameters: State Insurance Departments and Marketplaces
After the Biden administration issued the proposed 2023 “Notice of Benefit and Payment Parameters,...
Stakeholder Perspectives on CMS’s 2023 Notice of Benefit and Payment Parameters: Insurers and Brokers
The Biden administration has proposed significant changes to the Affordable Care Act's health insura...
Stakeholder Perspectives on CMS’s 2023 Notice of Benefit and Payment Parameters: Consumer Advocates
In the recently released 2023 "Notice of Benefit & Payment Parameters," the Biden administration is ...
Ensuring the Adequacy of ACA Marketplace Plan Networks
Following the Trump administration’s decision to roll back federal network adequacy standards for ...
The Proposed 2023 Notice of Benefit & Payment Parameters: Implications for States
The Biden administration has proposed a range of new standards and policies for the Affordable Care ...
Navigator Guide FAQs of the Week: Will My Plan Deliver the Care I Need?
Provider networks and prescription drug coverage are important consideration for consumers when choo...
State Options Blog Series: Federal Regulators Relax ACA Health Plan Oversight, Creating Opportunities and Challenges for States
In the second of a multi-part blog series on state options in the wake of federal actions to roll ba...
Recent and Potential Regulatory Actions to Roll Back the ACA: State Options Blog Series
While members of Congress debate possible bipartisan actions on the ACA, the future sustainability o...
Relaxing the ACA’s Regulations: Stakeholders Respond to HHS’ Request for Information: Part 1—Insurers
The U.S. Department of Health & Human Services asked this spring for public comments on potential ch...
Amid Market Uncertainty, Trump Administration Retreats from Health Plan Oversight
In mid-April, the Trump administration announced it would stop monitoring marketplace plans for comp...
New Network Adequacy Rules: Less Federal Oversight, More Deference to States
In a soon to be finalized "market stabilization" rule, the Trump Administration has proposed a new a...
Reading the Fine Print: Do ACA Replacement Proposals Give States More Flexibility and Authority?
State leaders have been heartened by statements from the new President and Congressional leaders tha...
Quality Over Quantity? New Medicaid Network Adequacy Rules Illuminate Disparities Among Insurance Program Standards
Narrow network plans, or plans with a limited network of providers, present problems for consumers a...
Want to Know Whether Your Health Plan’s Network is Narrow or Broad? You’ll Need to Wait Another Year
The Obama Administration has delayed a promised rollout of a new network size rating system on healt...
Technology’s Impact on the Way We Access Health Care Continuing to Raise Questions
Technology is transforming how we access and receive health care through the use of telemedicine. As...
Major New Rule Seeks to Modernize & Improve Quality of Medicaid Managed Care
Last week the Centers for Medicare and Medicaid Services released a much-anticipated final rule on M...
Telemedicine: Another Tool in the Toolkit to Meet Network Adequacy Standards?
Health plans have been increasingly narrowing their provider networks, raising concerns about gaps i...
President Obama’s Budget Takes State-Level Debates over Surprise Out-of-Network Bills to National Policymakers
President Obama's 2017 budget includes a new proposal to help protect consumers from unexpected char...
NAIC Fall Meeting: As One Issue Winds Down, Another Rears Its Head
At the NAIC’s most recent meeting, two issues stood out: the long-coming Network Adequacy Model Ac...
Georgetown Experts Help States Weigh Solutions to Protect Consumers from Unexpected Medical Bills
As reports of patient encounters with unexpected provider bills continue to make headlines, state an...
The Next Big Thing in Network Adequacy: The NAIC Model Act
In November, the National Association of Insurance Commissioners (NAIC) will finalize the Network Ad...
The NAIC’s Summer Meeting: Updating Network adequacy and ACA Transparency Requirements
The National Association of Insurance Commissioners (NAIC) has been hard at work updating a model st...
Telemedicine and its Effect on the Regulatory Landscape
Some states are making policies related to the emergence of telemedicine or the delivery of health c...
New Proposed Rules for Network Adequacy for Medicaid Managed Care Plans – Lessons Learned from Medicare & the Marketplaces
The Centers for Medicare and Medicaid Services (CMS) recently released draft regulations governing M...
Implementing the Affordable Care Act: State Regulation of Marketplace Plan Provider Networks
Narrow network plans were common on the health insurance marketplaces in 2014. In a new issue brief ...
New Georgetown Report: Assessing Consumers’ Experience with ACA Coverage through the Eyes of State Consumer Assistance Programs
While the ACA has successfully resulted in 16.4 million newly insured people, we don't yet know a lo...
While All Eyes Are On Upcoming SCOTUS Decision, NAIC Work Continues
The NAIC Spring meeting tackled a number of ACA implementation issues important to consumers. JoAnn ...
Health Plan Narrow Networks: Highlighting Transparency Deficiencies for Consumers
A recent conference hosted by the Robert Wood Johnson Foundation on health system transparency allow...
New Report on States’ Oversight of Health Plan Network Adequacy
The consumer representatives to the National Association of Insurance Commissioners (NAIC) released ...
A Busy November Weekend: Launch of OE2 and the NAIC Fall National Meeting
November 15th marks the start not only of open enrollment into the Affordable Care Act's health insu...
Helping States Address Transparency of Health Plan Provider Networks
During the past few months, CHIR faculty have examined the proliferation of narrow provider networks...
CHIR Launches First in Video Series: Coffee Conversations on Timely Health Insurance Topics
We at the Center on Health Insurance Reforms are excited to share the first of an upcoming video ser...
Changing Provider Networks In Marketplace Health Plans: Balancing Affordability And Access To Quality Care
While narrow provider networks are by no means new to health insurance, the practice has received re...
Enrolled in Coverage That Just Got Harder to Use: Consumer Options When the Network Changes Mid-Year
Now that open enrollment is over, consumers are starting to raise questions about their coverage. On...
More New Resources Available to State Regulators
A set of new tools for state insurance regulators, as well as updated versions of some older resourc...
Back in the Day — Lessons Learned from Pre-reform Days: Going “Old School” with Narrow Networks
While we’re struggling with Affordable Care Act (ACA) issues, there's value in taking the time to ...
Narrow Networks Under the ACA: Financial Drivers and Implementation Strategies
The ACA's essential health benefits and metal tier coverage standards, guaranteed issue, and communi...
Changing Health Plans, Changing Provider Networks: What They Mean for Consumers and How States Can Help
Did the President tell the truth when he told the American people: "If you like your doctor, you can...
Narrow Networks: Who’s Looking Out for Consumers?
Media outlets are reporting on a trend towards narrow network health plans offered through the Affor...
New Report on ACA Implications for State Network Adequacy Standards
The Affordable Care Act promises consumers a more comprehensive set of health insurance benefits, bu...
Multi-State Plan Program Final Rule: OPM's Balancing Act
The Office of Personnel Management recently issued a final rule on the multi-state plan program in w...